Ignoring Endemic Problems In Healthcare Is Extremely Unwise

On the day it was reported that the President was poised to sign the National Health Insurance Bill, the media also featured the following headlines:

• Two ambulances for 100 villages in the EC
• Themba Hospital workers on strike
• ‘Our loved ones rely on those machines’ – Tembisa Hospital allegedly without power for 4 hours
• Budget cuts hit WC Health
• Cost of not treating mental health is much more than a human rights issue
• Murder at Gqeberha psychiatric hospital: patient smashed into wall and severely beaten (by another patient)
• Complaints of poor service delivery at Dr Harry Surtie Hospital
• Drama, protests and misery at locked rural clinics
• Lusaka Clinic delay due to contractual disputes.

In two days since, all this week, news has broken of budget constraints that are severely hampering service provision at the National Department of Health, making it unable to hire hundreds of recently qualified junior doctors and also at the Western Cape Health Department, where healthcare professionals have asked for devastating cuts to be immediately stopped. 

It is a stretch to argue that the above are all solely a consequence of resource imbalances or a two-tier healthcare system. While resource imbalances and inequities are severe challenges that must be addressed, so are management deficiencies, years of under-training of skills across the healthcare system, an inability to keep the lights on, and the inevitable consequences on healthcare and other budgets of industrial-scale corruption in public and areas in the private sector.

To ignore or avoid taking practical steps to address the many challenges we collectively face to continue to focus solely on making the argument for the National Health Insurance is wilful and an unwise turning away from the endemic problems in the healthcare system that risk its ability to deliver the right to healthcare. This bodes ill for a future where none of the keenest protagonists for the Fund will directly suffer from any future failures caused by unresolved weaknesses. Future generations will bear that load.

The Hospital Association of South Africa and its members have for years paid close attention to many of the endemic weaknesses in the healthcare system and have unstintingly engaged with a range of stakeholders to suggest collaborative solutions. We are deeply concerned that our contributions and those of many others in the private sector to strengthen the National Health Insurance Bill regarding cost, constitutionality and unintended and unclear impacts – not to negate it –  have simply been ignored. The inevitable consequence is shaken trust.

Building the most consequential healthcare reforms to ensure the uninterrupted healthcare needs of all South Africans for generations to come should not be tackled in such an arbitrary and reckless manner.